The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2007
The impact of the accreditation council for graduate medical education work-hour regulations on the surgical experience of orthopaedic surgery residents.
The advent of the eighty-hour workweek regulations generated a great deal of controversy over the potential loss of operative experience for general surgery and surgical specialty residents. We believed an investigation to review the operative experience of orthopaedic surgery residents before and after the adoption of the Accreditation Council for Graduate Medical Education duty-hour guidelines would provide important information in this debate. ⋯ Although many aspects of surgical training may be affected by the new work-hour restrictions, our review of the operative experience of orthopaedic surgery residents at a single institution demonstrated no significant differences before and after the implementation of the eighty-hour workweek.
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J Bone Joint Surg Am · Apr 2007
Randomized Controlled Trial Comparative StudyLateral entry compared with medial and lateral entry pin fixation for completely displaced supracondylar humeral fractures in children. A randomized clinical trial.
Closed reduction and percutaneous pin fixation is the treatment of choice for completely displaced (type-III) extension supracondylar fractures of the humerus in children, although controversy persists regarding the optimal pin-fixation technique. The purpose of this study was to compare the efficacy of lateral entry pin fixation with that of medial and lateral entry pin fixation for the operative treatment of completely displaced extension supracondylar fractures of the humerus in children. ⋯ Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2007
Fresh stored allografts for the treatment of osteochondral defects of the knee.
Osteochondral allograft reconstruction of articular cartilage defects is a well-established cartilage repair strategy. Currently, fresh osteochondral allograft tissue is commercially available to clinicians approximately thirty days following graft harvest. Little clinical information is available on the outcome of patients who have been treated with fresh allografts stored for several weeks or more. The purpose of this study was to prospectively analyze the clinical outcome and graft morphology of patients who received fresh, hypothermically stored, allograft tissue for the treatment of symptomatic chondral and osteochondral defects of the knee. ⋯ Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2007
Isolated arthroscopic biceps tenotomy or tenodesis improves symptoms in patients with massive irreparable rotator cuff tears.
Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears and may be responsible for shoulder pain and dysfunction. The purpose of this study was to evaluate the clinical and radiographic outcomes of isolated arthroscopic biceps tenotomy or tenodesis as treatment for persistent shoulder pain and dysfunction due to an irreparable rotator cuff tear associated with a biceps lesion. ⋯ Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Apr 2007
Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.
Over the past decade, there has been an increase in the number of revision total hip and knee arthroplasties performed in the United States. The purpose of this study was to formulate projections for the number of primary and revision total hip and knee arthroplasties that will be performed in the United States through 2030. ⋯ These large projected increases in demand for total hip and knee arthroplasties provide a quantitative basis for future policy decisions related to the numbers of orthopaedic surgeons needed to perform these procedures and the deployment of appropriate resources to serve this need.